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Elinor Josephson of Boca Raton, speaking outside the Palm Beach Gardens office of of Florida’s U.S. Sen. Marco Rubio May 30, said proposed changes to the health care law could make it much more expensive for people to get coverage of pre-existing conditions such as her congenital heart condition. (Charles Elmore/Palm Beach Post).

“It’s just not the way it’s supposed to be in the United States of America,” said Elinor Josephson, 58, of Boca Raton.

Scores of such gatherings across the country highlight the stakes as Rubio and Senate colleagues take up the thorniest legislative issue of President Trump’s first five months in office.

Only 8 percent of the public wants the Senate to pass the House rollback of Obamacare as it stands, according to a Kaiser Health Tracking Poll released May 31. About 55 percent say make major changes or don’t pass anything.

“No parent should ever have to decide if they can afford to save their child’s life,” Kimmel said in an emotional monologue about his newborn last month.

It’s a personal issue to Josephson as well. She said she had heart operations as a child and as recently as September for a condition known as “tetralogy of fallot,” which Kimmel’s son also has. That kind of care represents not an optional consumer whim but what people “need to live,” she said. Procedures can cost hundreds of thousands of dollars at a time.

Josephson said she feels fortunate to have employer health coverage through the Boca Raton temple where she works, but millions of people do not.

“Without insurance, you can’t afford the health care we’re lucky enough in this country to have,” Josephson said.

Changes to the Affordable Care Act that the House passed could lower costs for younger, healther and higher-income people, slashing close to $1 trillion in taxes for corporations and people making more than $200,000 a year. But the American Health Care Act would also push 23 million people out of coverage by 2026 compared with keeping current law in place, and could saddle those already battling serious health issues with “extremely high costs,” the Congressional Budget Office said.

The House bill would give states a way to opt out of Obamacare’s rules governing how insurers must treat people with pre-existing conditions. The law now requires them to treat sick people the same way as healthy ones in a given territory.

Letting the states opt out of restrictions like that could make policies cheaper for healthy people, but it opens the door to placing the sick in high-risk pools that would likely cost them much more than they pay now, CBO officials said. Without naming individual states, they projected about a sixth of the U.S. population would live in states that extensively opt out of Obamacare mandates.

Yet it means little to say people with pre-existing conditions have access to coverage if they cannot reasonably afford it, Josephson said.

An estimated 3.1 million Flordians have pre-existing conditions ranging from diabetes to heart disease.

The House bill earmarked $8 billion over 10 years to help states reduce costs for people with pre-existing conditions. Bill supporters say up to $138 billion would be available to help states in a variety of ways. CBO projected that will still leave many people with such conditions facing much higher costs than they do now and cause some high-risk markets to become “unstable.”

President Trump tweeted this week, “I suggest that we add more dollars to Healthcare and make it the best anywhere. ObamaCare is dead — the Republicans will do much better!”

Rubio, Florida’s Republican U.S. senator, was not in Palm Beach Gardens when Josephson and dozens of protesters from groups including Florida Voices for Health, union SEIU, New Leaders Council and Planned Parenthood spoke outside his office Tuesday. A spokeswoman referred a reporter to recent Rubio statements.

“The House product, I know they worked hard on it; that is not the Senate bill,” Rubio said in a Facebook video May 23. “The Senate is going to do its own bill.”

Rubio expressed concerns about making sure Florida gets a fair share of Medicaid dollars, which would be reduced by $880 billion nationwide over 10 years compared with current law and handed to states in capped amounts in the House bill. He voiced support for some elements the House included, such as greater flexibility for states and insurers to decide what coverage to offer.

“This is just in its infancy,” Rubio said. “We’re working on those details now. Our goal is to make it better than what it is today, not worse.”

Outside Rubio’s office in Palm Beach Gardens, attorney David Sholl said another important facet of the Affordable Care Act marketplace is its effect on entreprenuers. These could be Millennials under 35 like him or older people leaving a traditional corporate job, by choice or necessity.

The current law helps “young people like me to take the great risk of starting our own businesses,” he said, rather than fearing to stray from the health plans of big employers.

As for pre-existing conditions, Sholl recalled for years he tried not let anyone know he had asthma and downplayed attacks but had less reason to worry about those financial implications after the ACA passed.

Under the House bill, people with higher incomes would enjoy the same limited tax credits as lower earners to help offset health insurance costs. People with lower incomes would lose Obamacare subsidies, including $5.2 billion in Florida to lower premiums, most in the nation. The bill would let insurers charge people 5o to 64 up to five times more than younger ones, up from three times now. AARP opposes that as an “age tax.”

Among the losers would be a 64-year-old making $26,500 a year and receiving government subsidies on the Affordable Care Act exchange to limit his out-of-pocket cost to about $1,700 a year. His costs would rocket 850 percent to $16,100 under the House bill, more than half his total income.

Democrat Bill Nelson, Florida’s other U.S. senator, said in his West Palm Beach office Wednesday that he sees little consensus on the other side of the aisle.

“I think the majority leader in the Senate is having trouble getting 50, just 50, Republican Senators to come together in agreeement,” Nelson said. “None of them support the House-passed Republican bill because it’s a disaster. It takes away health insurance from 23 million people and it eviscerates Medicaid.”

Medicaid covers low-income people including 70 percent of the seniors in nursing homes in Florida, said Nelson, a former elected state insurance commissioner.

Letting insurers pick and choose what they want to cover represents a step back toward pre-ACA days, Nelson said. That’s when insurers could define things from heart disease and cancer to asthma as pre-existing conditions and charge more than ordinary people could afford if not deny coverage outright.

“America and I know Florida doesn’t want to go back to that,” he said.